The Cause And Management Of The Disorder Of Blood Supplying Of Expanded Flaps After Reconstruction

As the expanded flaps could provide "additional" similar soft tissue in color, texture and thickness, they are widely used in plastic reconstruction. However,after reconstruction, the incidence of disorder of blood supplying of expanded flaps remains high, this does affect the results of operations. The article investigates the cause and management of the disorder of blood supplying of expanded flaps after reconstruction, so as to provide some help in preventing and treating the disorder of blood supplying of expanded flaps.The paper consists of two parts:review of literatures and clinical practice.The review contains the histological and vascular changes of expanded skin, the factors which affect the blood circulation of the expanded flaps, the managements of the expanded flaps with disorder of blood supplying, and so on.In the clinical practice part, from January 2009 to October 2010,325 patients 903 expanded flaps were reviewed retrospectively for the disorder of blood supplying. The cause and management of the expanded flaps with disorder of blood supplying were also analyzed.The incidence of disorder of blood supplying of the expanded flaps:total 4.76%, upper limbs 11.83%, trunk 7.10%, neck 4.60%, lower limbs2.86%, head and face2.54%, local skin flap 3.37%, ortho-position skin flap 21.43%, distant skin flap 57.14%.The cause of the disorder of blood supplying of expanded flaps:large length to width ratio 27.91%, thin of expanded flap in central part 16.28%, hematoma 18.60%, infection 9.3%, large of flap tension 9.3%, containing scar tissue in expanded flap 11.63%, removal of envelope 6.98%.In conclusion, there is a significant relationship between the disorder of blood supplying of expanded flaps and the expanded position. There is also a significant relationship between the disorder of blood supplying of expanded flaps and the pattern of expanded flap. As to the distant and ortho-position skin flaps with large length to width ratio, the flap delaying operation can improve the survival of the expanded skin flap. The expanded flaps which have disorder of blood supplying after reconstruction should be treated properly and promptly. This study provides evidence to support the management of the disorder of blood supplying, which is an effective, reliable and valuable technique for the patient.